Affiliations: Digestive Oncology Unit, | Biostatistics Unit and | Radio-Analysis Laboratory, CRLC Val d'Aurelle-Paul
Lamarque, 34298 Montpellier, France
Note: [] Digestive Oncology Unit, CRLC Val D'Aurelle, Parc
Eurom\'edecine, 34298 Montpellier-Cedex 5, France
Abstract: Carcinoembryonic antigen (CEA) and CA 19-9 are both widely used in
the follow up of patients with gastrointestinal cancer. More recently another
tumor marker, named CA 72-4 has been identified and characterized using two
different monoclonal antibodies B72.3 and CC49. Several reports evaluated CA
72-4 as a serum tumor marker for gastric cancer and compared its clinical
utility with that of CEA or CA 19-9; few reports concerned its prognostic
value. In the present study, CA 72-4 is evaluated and compared with CEA and CA
19-9 in various populations of patients with gastric cancer and benign disease;
for 52 patients with gastric adenocarcinoma and 57 patients without neoplastic
disease CEA, CA 19-9 and CA 72-4 were evaluated before treatment. Sensitivity
of the tumor markers CA 72-4, CA 19-9 and CEA at the recommended cut-off level
in all 52 patients were 58%, 50% the sensitivity increased to 75%. of these
markers, for non metastatic patients, multivariate analyses indicated that none
of the markers were significant, when adjusted for gender and age (which were
indicators of poor prognosis); patients with abnormal values of CA72-4 tended
to have shorter survival than patients with normal values
(p<0.07). In the metastatic population, only high values of
CA19-9 (p<0.02) and gender (women)
p<0.03) were indicators of poor prognosis in univariate
analysis; multivariate analysis revealed that both CA72-4
(p=0.034) and CA19-9 p=0.009), adjusted
for gender were independent prognostic factors. However, CA72-4 lost
significance (p=0.41) when adjusted for CA19-9 and gender,
indicating that CA19-9 provides more prognostic information than CA72-4. When limited to the metastatic male population with normal values of
CA 19-9 and CEA, CA 72-4 pretherapeutic positive levels were associated with a
worse prognosis (p<0.005). In conclusion, this study suggests that the addition of CA 72-4 to
CEA and/or CA 19-9 could improve sensitivity in gastric cancer. The prognostic
role of this marker is not yet clearly demonstrated but its usefulness in the
monitoring of gastric cancer should be taken into account.
